My doctor sent me to the pharmacy with a prescription for a three month’s supply of “Diaphragm – whatever brand is available”.

…

…

PH insisted on coming to the pharmacy with me so he could have a good laugh at pharmacist’s dumbfounded expression.

Let me backtrack.

I went in to see my doctor, saying I wanted to “discuss my birth control options” because somehow “I want her to measure my vagina” wasn’t my first choice of words when speaking to the receptionist.

My doctor told me that the mini-pill would be best since I’m breastfeeding. I found that odd because my OB-GYN said I should take no hormonal stuff at all. So I said I’d rather avoid hormonal routes altogether. She said that leaves me with the IUD.

Now, I’ve thought for years about getting an IUD after my first child. Sounds easy. However, so many people have gone “Nooooo, don’t doooo it” whenever I have brought it up that I’ve been put off the whole idea.

PH and my mother alike are terrified that it’ll scar my uterus and leave me infertile, and we want at least one other kid. A friend of mine told me horror stories about what happened to HER friends who got IUDs and ended up with horrible hospitalizations for vague reasons. Only one friend (who has used an IUD for 10 years and is done having kids) has endorsed the idea.

So that pretty much left me with the option of diaphragm, and now my doctor wasn’t even presenting it as an option.

“What about a diaphragm?” I asked the doctor.

“Oh… I have a couple patients who use those…” said my doctor. “You realize that it isn’t as effective as an IUD or homonal contraception? They’re only about 80% effective.”

“That’s ok. We want more kids, just not right now. If I do get pregnant, it isn’t the end of the world.”

“Do you need a prescription for one?”

“I have no idea.”

“How much do they cost, do you know?” my doctor asked.

“I… don’t know,” I said, feeling like the conversation was a little backwards.

“Well… why don’t I write you a prescription. I’ll just say whatever brand is available because I don’t know what brands are out there.,” said my doctor, scribbling on a pad. “Why don’t I get you a six month’s supply to start.”

I felt a little at sea in this conversation. “Um… I thought they were reusable.”

“Right. Yes. Well, why don’t I write a prescription for three months, and you can tell me if it is working for you. Call me if you have any problems, ok?”

I took the prescription because I was riddled with self-doubt. Part of me was saying “but I thought she had to fit me for one of these!” and the rest of me was saying “Shut up, if that isn’t right you’re going to look like an weirdo who wants doctors to prod her vagina unnecessarily, and if she is wrong, then clearly she doesn’t know what to do anyway, so what’s the point?”

And that is how I came to be standing at the pharmacy with a prescription that made no sense. The pharmacist gave me a really weird look when I handed it to her apologetically.

“My doctor is useless, I’m sorry,” I said. “Is there anything you can do with this?”

She wrinkled her brow, wrote down the available sizes of diaphragm, handed the prescription back to me and then commented on the fact that my son’s prescription was also wrong.

“I see your doctor has taken your son down from 15 mg twice a day to 10 mg twice day.”

“Oh Gawd.” I said, looking at the other piece of paper. “My doctor’s an idiot. She meant to leave it the same. She thinks Ranitidine comes in 10mg/ml concentrations, even though I keep telling her it’s 15 mg/ml. So I told her he was still getting 1 ml twice a day, and she thought that meant 10 mg instead of 15mg.”

The pharmacist looked dubious.

“It’s for GERD?”

“Yes.”

“How much does he weigh? 6.6 kg?” She pulled out her calculator and tapped away. “Well, 10 mg BID is well below the recommended dosage for GERD, and even 15mg is quite low. The old dosage should be fine and you could even go as high as 20 mg twice a day, so I’ll give it the old label.”

“Thank you,” I said meekly, and I slunk out with a chuckling PH trailing behind me.

Now my first period in over a year has arrived and I still don’t have a diaphragm because I don’t want to go back to my doctor and force her to measure my gooch against her will.

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37 thoughts on “Dr. Useless Strikes Again (TMI alert)”

don’t get pressured into any type of contraception! That’s your body… if your doctor is such a moron, find a new one… i know i know not as easy as it sounds, but if you call around and explain your worries, i’m sure someone will help you out.

as for the mini pill… we got Vi, it didn’t reduce my milk supply at all though… so i wouldn’t worry about that. i went on the regular pill while nursing Vi and it was safe and didn’t change my milk supply either…. but now we’re awaiting number 3. i’m guessing hubs just has military sperm, bound and determined to destroy the egg… i’ve heard both sides of the IUD and mirena story… they scare me, but the docs push them.

i would say do what feels right to you. if you need to be fitted for a diaphragm and your doc doesn’t feel comfortable, ask for a referral to the gyno.

and excuse me, but why the hell is there a “g” in diaphragm? i hate english!

That doctor is insane! Ack! Can you switch? I don’t know how the Canadian health system works for this.

If you were in the U.S. I’d be trying to find you a feminist women’s health clinic. They sometimes go overboard the other way; I was asked if I’d mind being measured for a diaphragm just so the health worker could practice. And then they gave me a prescription for one, although I am not sure what I need it for, since I’m a monogamous lesbian.

I don’t think IUDs are all that more effective, honestly. It might just be something about my family’s uteri, but five women in my family have gotten pregnant and carried babies to term with IUDs. I was one of those babies – they even took the IUD out, expecting me to spontaneously abort, and that didn’t happen. While I’m grateful I didn’t, it’s rather annoying to be living proof of how a birth control method fails and know there really aren’t many better options out there.

I can go to whatever doctor I like (I’ve shown up in a hospital emergency room with “a bad cold” before and been treated within a couple of hours) , but finding a doctor who is taking patients can be a problem. We have a brain drain to the states, where doctors get paid far more. My doctor was the only doctor in my area who was taking patients, probably because she is brand new.

I could go to a walk-in clinic, but that seems a little odd…

I love that pretty much all birth control has a failure rate. I use it as an argument against hardcore Christians who believe that God wouldn’t give them children if he didn’t want those children to be born.
“You think a pill or an IUD can thwart God? If he wants you to have a baby, you’ll have one whether or not you use birth control, but if he didn’t want to give us SOME choice in the matter, why would have let birth control work at all?”

I was on the mini-pill when I breastfed both babies. My only complaint with it was that you absolutely must take it at the same time every day, and I’m sorry, but a post-partum breastfeeding mother is incapable of remembering something like that. At least in my world.

I had a Mirena until four or five months ago. If you’d like to hear my experiences with it, drop me an email – I don’t want to hijack your comments with it. Suffice it to say you’re able to leave them in for five years, and after two and a half I had that sucker yanked out, even though we weren’t 100% sure at the time that another baby was something we wanted right then. (And FYI, my family doctor couldn’t fit me for the IUD or insert it – she had to refer me to an actual gynecologist. And a friend of mine who has a diaphragm had the same experience, so perhaps Dr. Useless should have gone the referral route instead).

Your doctor, however, is an idiot. Like, certifiably a dumbass. I know it’s hard to find a family doctor who is taking patients but maybe start looking, yes?

I know I blogged about my horrible periods with my IUD (non-hormonal old-fashioned copper coil, not the merena), but it seems to have settled down and I’m now quite happy with it – no extraneous hormones in my system, I don’t have to worry about it, and I still know what my cycle is doing. I wouldn’t get Dr Useless to insert it, though.

It’s strange how hard it is to find doctors who can do anything more complicated in the contraceptive line than prescribe the pill. I suppose I should be less surprised in Ireland, where the sale of contraceptives was only legalised in 1980.

Sorry you’re dealing with her uselessness. I would suggest asking for a referral to a specialist. My family doctor sent me to one immediately when I started asking about birth control options outside of the pill. I’m not sure whether or not it’s the same in your province, but here it has to be a gynecologist who inserts IUD’s, etc. anyway, so it makes sense to see one if you want to even put those options on the table. And if you approach it as “I’d like to see a specialist so that I can discuss some of the less common birth control options” I can’t see your doctor objecting. Clearly she is not well versed in them.

I was nervous about the IUD going into it. I researched the heck out of the thing, and had the same uncertainties as you mentioned. Overall, I found that the actual statistics on the kinds of difficulties I was hearing about seemed to really be quite low (depending on how you tend to be naturally shaped internally, I think). I won’t say I wasn’t a little nervous about all the Really Bad Stuff that was possible, but even the pill has Really Bad Stuff that’s possible. It just doesn’t tend to get as much hype. Anyway, I’m very happy with it now. …BUT if you know you’re planning on more kids and aren’t concerned about effectiveness ratings, I’m sure there are other options that might work out better for you at this stage. For reliable, temporary, non-hormonal birth control, the IUD seemed like pretty much the only option. If you don’t have to have that same certainty, there should be lots of options.

WOAH! That’s … that’s just downright disturbing! O.O I wouldn’t trust that doctor as far as I could throw her! Okay, inexperience is one thing, but she sounds potentially dangerous. What if she’d prescribed the wrong dosis the other way on that or any other medication?

I thought you had to see a gynecologist to get fitted for birth control measures? Not that I’d have a clue, I’ve never had an appointment with one in my life nor have I ever been on the pill. (I don’t want to mess with the chemical workings of my body. I’m an au naturale kinda gal!) Someone I know used a copper spiral between child #1 and #2 and that’s caused a number of health issues in both #2 and #3, but especially in #2. With the hormones, I wouldn’t want to take it if I was breastfeeding simply because it sounds far too likely for the hormones to come out in the breastmilk and that’s just a bad idea in general. :S

No advice on contraceptives, but I’d definitely suggest seeing a different doctor if you can. I don’t know what it’s like there, but here in Ontario, if you have a doctor, you’re technically not allowed to sign up to be a patient for another one. I guess this is because of shortages, and I think it’s bullshit. However, if your doctor is an idiot and you cry to the receptionist about how you won’t be getting your four-month old his vaccinations because you detest said doctor so much, they may take pity on you and accept you as a new patient of a different doctor. (Ask me how I know! :P)

Yeah, there are barely any here. We got super lucky that there were a few (like, three maybe?) and they all were at a clinic that’s actually close by and NOT downtown, where it’s hard to park. Very, very lucky.

from someone who used a diaphragm for several years, I will say I rather liked it and have seriously considered going back to it. In my youth, the pill killed my libido so bad it was pointless, and (as you said) condoms are a pain in the ass. So the diaphragm was great — most nights we pretty much knew it would be “the night” so you can put it in well in advance, then just leave it in overnight. When fitted properly (a challenge it seems in your case) and used with spermicide it can be 90%-ish effective. And in the spirit of TMI, is very handy when you have your period (like a mooncup thingy). I am back on the pill now, but have considered going off because of side-effects for me. Hoping you get it all sorted out and that is helpful info. 🙂

I found this post through a google search, because I recently also encountered the joy of attempting to obtain a diaphragm in Ontario. So basically, diaphragm fittings are a dying skill set among Canadian (and arguably, all) physicians. If your doctor is young, she has likely never fitted a diaphragm and probably will never be able to get that training.

I was lucky in that as a student, I go to my university’s student health facility. Of 12 doctors that practice there, 1 has the skillset to fit diaphragms. She’s in her 60s, and has the training because it was a more popular method 30 years ago.

She fit me, I ordered my diaphragms online from the UK (a site called Mistry’s Pharmacy) and they were much cheaper there than in Canada. Diaphragms are becoming obsolete because doctors push hormonal methods or other methods (IUDs) that are profitable to the pharmaceutical industry. A diaphragm, if purchased at a Canadian pharmacy, is around $65-80 (an IUD is upwards of $300-800). Diaphragms last for a few years if properly cared for. And they put birth control in the hands of women.

The failure rate is really only about 6% if used properly. You need to use spermicide with it, which is another issue in Canada. Nonoxynol 9 spermicides aren’t available anymore, so you have to order something called Contragel, which is more tolerable and uses lactic acid as the sperm-killing chemical. You can get it at well.ca.

If you’re serious about using the diaphragm as a method, you’ll have to call around to find a practitioner who skill knows how to fit. They require a set of fitting rings to measure your cervix.

I’m using it because after being on the pill for 12 years, I’m sick of hormones and being a slave to big pharm. I’m practicing fertility awareness and using the diaphragm. Where there’s a will, there’s a way…